DICOM CONFORMANCE STATEMENT FOR DC-8/DC-8 PRO/DC-8 CV/ DC-8 EXP/DC-8S DIAGNOSTIC ULTRASOUND SYSTEM

Transcription

1 DICOM CONFORMANCE STATEMENT FOR DC-8/DC-8 PRO/DC-8 CV/ DC-8 EXP/DC-8S DIAGNOSTIC ULTRASOUND SYSTEM

2 Version V Mindray All rights reserved SHENZHEN MINDRAY BIO-MEDICAL ELECTRONICS CO., LTD. Mindray Building, Keji 12th Road South, High-tech Industrial Park, Nanshan, Shenzhen , P.R. China

3 1 Conformance Statement Overview This document describes the conformance to the ACR-NEMA DICOM 3.0 Standard by the ultrasound system of DC-8/DC-8 PRO/DC-8 CV/DC-8 EXP/DC-8S. We specify ultrasound system generally refer to the products above in this document. The ultrasound system implements the necessary DICOM services to download worklists from an information system, save acquired Ultrasound (US) images and associated Structured Reports to a network storage device and/or removable media, print to a networked hardcopy device, query and retrieve the US images from a networked storage system, and inform the information system about the works actually done. Table 1 provides an overview of the supported network services, Table 2 lists the supported Media Storage Application Profiles, and Table 3 lists the supported Structured Report Templates. Table 1 NETWORK SERVICES SOP Classes User of Service (SCU) Transfer(Storage) Provider of Service (SCP) Verification Yes Yes Ultrasound Image Storage Yes Yes Ultrasound Multi-frame Image Storage Yes Yes Secondary Capture Image Storage Yes Yes Encapsulated PDF Storage Yes Yes Enhanced US Volume Storage Yes No Raw Data Storage Yes Yes Query/Retrieve Study Root Query/Retrieve Information Model FIND Yes No Study Root Query/Retrieve Information Model MOVE Yes No Workflow Management Modality Worklist Information Model Find Yes No Modality Performed Procedure Step Yes No Storage Commitment Push Model Yes No I

4 SOP Classes User of Service (SCU) Provider of Service (SCP) Print Management Basic Color Print Management Yes No Basic Grayscale Print Management Yes No Notes, Reports, Measurements, Transfer Comprehensive SR Storage Yes Yes Table 2 MEDIA SERVICES Media Storage Application Profile Compact Disk - Recordable Write Files (FSC / FSU) Read Files (FSR) STD-US-SC-SF&MF-CDR Yes / Yes 1 Yes DVD STD-US-SC-SF&MF-DVD STD-US-SC-SF&MF-DVD-RAM Yes / Yes 1 Yes USB Devices STD-GEN-USB-JPEG for Ultrasound images, compressed and uncompressed and Structured Reports Yes / Yes 1 Note: 1 Only acts as a FSU for media that may be written to multiple times. Yes Concept Name Table 3 STRUCTURED REPORTS Supported OB-GYN Ultrasound Procedure Report Echocardiography Procedure Report Vascular Ultrasound Report Breast Imaging Report Yes Yes Yes Yes II

5 2 Table of Contents FOR... 1 DC-8/DC-8 PRO/DC-8 CV/... 1 DC-8 EXP/DC-8S... 1 DIAGNOSTIC ULTRASOUND SYSTEM Conformance Statement Overview... I 2 Table of Contents... III 3 Introduction Review History Audience Remarks Terms and Definitions Acronyms, Abbreviations, and Symbols References Networking Implementation Model Application Data Flow Functional Definitions of AE s Sequence of Real World Activities AE Specifications Modality AE Network Interface Supported Communications Stacks TCP/IP Stack Physical Network Interface Additional Protocols Configuration AE Title/Presentation Address Mapping Configurable Parameters Media Storage Implementation Model Application Data Flow Functional Definition of AE s Sequencing of Real-World Activities File Meta Information Options AE Specifications Media Application Entity Specification Media Storage Application Profile DICOMDIR Attributes Augmented and Private Application Profiles Media Configuration SUPPORT OF CHARACTER SETS SECURITY Security Profiles III

6 7.2 Association level security Application level security ANNEXES IOD contents Created SOP Instances Usage of attributes from received IOD s Attribute Mapping Coerced/Modified fields Data Dictionary of private attributes Coded terminology and templates Grayscale Image Consistency Standard extended/specialized/private sop Classes Private Transfer Syntaxes A. Appendix : OB GYN structured reporting template A.1. TID (300) Measurement A.2. TID 1008 Subject Context, Fetus A.3. TID (5000) OB-GYN Ultrasound Procedure Report A.4. TID (SELFTMP-1) Fetal Cardiac Measurement Group A.5. TID (SELFTMP-2) Fetal ZScore A.6. TID (1001) OBSERVATION CONTEXT A.7. TID (5001) OB-GYN Patient Characteristics A.8. TID (5002) OB-GYN Procedure Summary A.9. TID (5003) OB-GYN Fetus Summary A.10. TID (FINDING_1) Fetal Description A.11. TID (FINDING_2 ) Fetus Limbs A.12. TID (FINDING_3) Fetal Cardiology A.13. TID (FINDING_4) Fetal Brain A.14. TID (FINDING_5) Spine A.15. TID (FINDING_6) Fetal Environment A.16. TID (FINDING_7) Maternal Description A.17. TID (5004)Fetal Biometry Ratio Section A.18. TID (5005) Fetal Biometry Section A.19. TID (5006) Fetal Long Bones Section A.20. TID (5007) Fetal Cranium Section A.21. TID (5008) Fetal Biometry Group A.22. TID (5009) Fetal Biophysical Profile Section A.23. TID (5010) Amniotic Sac Section A.24. TID (5011) Early Gestation Section A.25. TID (5012) Ovaries Section A.26. TID (5013) Follicles Section A.27. TID (5014) Follicle Measurement Group A.28. TID (5015) Pelvis And Uterus Section A.29. TID (5025) OB-GYN Fetus Vascular Ultrasound Measurement Group A.30. TID (5026) OB-GYN Pelvic Vascular Ultrasound Measurement Group A.31. CID (228) Equation or Table A.32. CID (244) Laterality IV

7 A.33. CID (3627) Measurement Type A.34. CID (12005) Fetal Biometry Measurements A.35. CID (12006) Fetal Long Bones Measurements A.36. CID (12007) Fetal Cranium A.37. CID (12009) Early Gestation Biometry Measurements A.38. CID (12013) Gestational Age Equations and Tables A.39. CID (12014) Fetal Body Weight A.40. CID (12015) Fetal Growth Equations and Tables A.41. CID (12119) Vascular Ultrasound Property A.42. CID (12120) Blood Velocity Measurements A.43. CID (12121) Vascular Indices and Ratios A.44. CID (12122) Other Vascular Properties A.45. CID (12140) Pelvic Vasculature Anatomical Location A.46. CID (12141) Fetal Vasculature Anatomical Location A.47. CID (SELFCID-1) Fetal Z-Score A.48. Mapping between Modality measurements and DICOM Concepts A OB-GYN Measurements A Vasculature Anatomic Location A OB-GYN Vascular Measurements A OB-GYN Cardic Measurements A Biophysical Profile Measurements B. Appendix : Cardiac structured reporting template B.1. TID (5200) Echocardiography Procedure Report B.2. TID(1001) Observation Context B.3. TID (5201) Echocardiography Patient Characteristics B.4. TID (SELFTMP-2) Echo Procedure Summary Section B.5. TID (5202) ECHO SECTION B.6. TID (5203) Echo Measurement B.7. CID (12200) Echocardiography Left Ventricle B.8. CID (12201 ) Left Ventricle Linear B.9. CID (12202) Left Ventricle Volume B.10. CID (12203) Left Ventricle Other B.11. CID (12204) Echocardiography Right Ventricle B.12. CID (12205) Echocardiography Left Atrium B.13. CID (12206) Echocardiography Right Atrium B.14. CID (12207) Echocardiography Mitral Valve B.15. CID (12208) Echocardiography Tricuspid Valve B.16. CID (12209) Echocardiography Pulmonic Valve B.17. CID (12210) Echocardiography Pulmonary Artery B.18. CID (12211) Echocardiography Aortic Valve B.19. CID (12212) Echocardiography Aorta B.20. CID (12214) Echocardiography Pulmonary Veins B.21. CID (12215) Echocardiography Vena Cavae B.22. CID (12217) Echocardiography Cardiac Shunt B.23. CID (12218) Echocardiography Congenital B.24. CID (12220) Echocardiography Common Measurements V

8 B.25. CID (12221) Flow Direction B.26. CID (12222) Orifice Flow Properties B.27. CID (12224) Ultrasound Image Modes B.28. CID (12226) Echocardiography Image View B.29. CID (12227) Echocardiography Measurement Method B.30. CID (12228) Volume Methods B.31. CID (12229) Area Methods B.32. CID (12230) Gradient Methods B.33. CID (12231) Volume Flow Methods B.34. CID (12232) Myocardium Mass Methods B.35. CID (12233) Cardiac Phase B.36. CID (12234) Respiration Phase B.37. CID (12239) Cardiac Output Properties B.38. CID (12240) Left Ventricle Area B.39. CID (90000) Pericardial disease B.40. Mapping between Modality measurements and DICOM Concepts B Left Ventricle Measurements B Right Ventricle Measurements B Left Atrium Measurements B Right Atrium Measurements B Aortic Valve Measurements B Mitral Valve Measurements B Pulmonic Valve Measurements B Tricuspid Valve Measurements B Aorta Measurements B Pulmonary Artery Measurements B Vena Cava Measurements B Pulmonary Venous Structure Measurements B Cardiac Shunt Study Measurements B Congenital Anomaly of Cardiovascular System Measurements B Pericardial Disease Measurements B Heart Rate Measurements C. Appendix : Vascular structured reporting template C.1. TID (5100) Vascular Ultrasoud Report C.2. TID (1001) Observation Context C.3. TID (5101) Vascular Patient Characteristics C.4. TID (5102) Vascular Procedure Summary Section C.5. TID (5103) Vascular Ultrasound Section C.6. TID (5104) Vascular Ultrasound Measurement Group C.7. CID (12104) Extracranial Arteries C.8. CID (12105) Intracranial Cerebral Vessels C.9. CID (12106) Intracranial Cerebral Vessels (unilateral) C.10. CID (12107) Upper Extremity Arteries C.11. CID (SELFCID-2) Upper Extremity Arteries(unilateral) C.12. CID (12108) Upper Extremity Veins C.13. CID (12109) Lower Extremity Arteries VI

9 C.14. CID (12110) Lower Extremity Veins C.15. CID (12112) Abdominal Arteries (unilateral) C.16. CID (12114) Abdominal Veins (unilateral) C.17. CID (12115) Renal Vessels C.18. CID (12116) Vessel Segment Modifiers C.19. Mapping between Modality measurements and DICOM Concepts C Vascular Measurements C Extracranial Arteries C Intracranial Cerebral Vessels C Intracranial Cerebral Vessels (unilateral) C Upper Extremity Arteries C Upper Extremity Arteries(unilateral) C Upper Extremity Veins C Lower Extremity Arteries C Lower Extremity Veins C Abdominal Arteries (unilateral) C Abdominal Veins (unilateral) C Renal Vessels D. Appendix : Breast Imaging structured reporting template D.1. TID 1400 Linear Measurement Template D.2. TID (4200) BREAST IMAGING REPORT D.3. TID (4201) BREAST IMAGING PROCEDURE REPORTED D.4. TID (4202) BREAST IMAGING REPORT NARRATIVE D.5. TID (SELFTMP-3) BREAST IMAGING SUMMAY D.6. TID (4206) BREAST IMAGING REPORT FINDING SECTION D.7. TID (4208) BREAST IMAGING REPORT SUPPLEMENTARY DATA D.8. TID (SELFTMP-4) BREAST MASS FINDING D.9. TID (SELFTMP-5) BREAST MASS MEASUREMENT D.10. TID (SELFTMP-6) BREAST MASS ANALYSIS D.11. Mapping between Modality measurements and DICOM Concepts D Breast Measurements VII

10 3 Introduction 3.1 Review History DOCUMENT VERSION DATE OF ISSUE DESCRIPTION 1.0 Oct. 26, 2011 Creation of the document 2.0 Jun.27,2012 Added 3D/4D image Storage; Revised structured reporting template. 3.0 Feb Update Cardiac and OB GYN structured reporting template. 3.2 Audience This document is intended for potential customers, system integrators of medical equipment, marketing staff interested in system functionality and software designers implementing DICOM interfaces. It is assumed that the readers of this document are familiar with the DICOM Standard and with the terminology and concept which are used in the Standard. If readers are unfamiliar with DICOM terminology they should read the DICOM Standard, prior to reading this DICOM Conformance Statement document. 3.3 Remarks The scope of this DICOM Conformance Statement is to facilitate integration between Mindray Products and other DICOM products. The Conformance Statement should be read and understood in conjunction with the DICOM Standard. DICOM by itself does not guarantee interoperability. The Conformance Statement does, however, facilitate a first-level comparison for interoperability between different applications supporting compatible DICOM functionality. This Conformance Statement is not supposed to replace validation with other DICOM equipment to ensure proper exchange of intended information. In fact, the user should be aware of the following important issues: The comparison of different Conformance Statements is the first step towards assessing interconnectivity and interoperability between Mindray medical equipment and other DICOM conformant equipments. Test procedures should be defined and executed to validate the required level of interoperability with specific compatible DICOM equipment, as established by the healthcare facility. 1

11 The DICOM standard will evolve to meet the user s growing requirements. Mindray is actively involved in the development of the DICOM standard,. Therefore, Mindray reserves the right to make changes to its products or to discontinue its delivery. The Ultrasound System follows the IHE SWF, PDI, ED Profiles. 3.4 Terms and Definitions Abstract Syntax the information agreed to be exchanged between applications, generally equivalent to a Service/Object Pair (SOP) Class. Examples: Verification SOP Class, Modality Worklist Information Model Find SOP Class, Computed Radiography Image Storage SOP Class. Application Context the specification of the type of communication used between Application Entities. Example: DICOM network protocol. Application Entity (AE) an end point of a DICOM information exchange, including the DICOM network or media interface software; i.e., the software that sends or receives DICOM information objects or messages. A single device may have multiple Application Entities. Application Entity Title the externally known name of an Application Entity, used to identify a DICOM application to other DICOM applications on the network. The Called AE Title defines the intended receiver of an Association. Nevertheless, the Calling AE Title defines the requestor of an Association. Application Profile - A Media Storage Application Profile defines a selection of choices at the various layers of the DICOM Media Storage Model which are applicable to a specific need or context in which the media interchange is intended to be performed. Association a network communication channel set up between Application Entities. Association Establishment - an Association Establishment is the first phase of communication between two DICOM Application Entities. The AEs use the Association Establishment to negotiate how data will be encoded and the type of data to be exchanged. Attribute a unit of information in an object definition; a data element identified by a tag. The information may be a complex data structure (Sequence), itself composed of lower level data elements. Examples: Patient ID (0010,0020), Accession Number (0008,0050), Photometric Interpretation (0028,0004), Procedure Code Sequence (0008,1032). DICOM File Format - the DICOM File Format provides a means to encapsulate in a File the Data Set representing a SOP Instance related to a DICOM Information Object. DICOM Message Service Element (DIMSE) a DIMSE defines the services and protocols utilized by an Application Entity to exchange messages. File - a File is an ordered string of zero or more bytes, where the first byte is at the 2

12 beginning of the file and the last byte is at the end of the File. Files are identified by an unique File ID and may by written, read, or deleted. File Meta Information - the File Meta Information includes identifying information on the encapsulated Data Set. It is a mandatory header at the beginning of every DICOM File. Information Object Definition (IOD)- the specified set of Attributes that comprise a type of data object; does not represent a specific instance of the data object, but rather a class of similar data objects that have the same properties. The Attributes may be specified as Mandatory (Type 1), Required but possibly unknown (Type 2), or Optional (Type 3), and there may be conditions associated with the use of an Attribute (Types 1C and 2C). Examples: Print Job IOD. Joint Photographic Experts Group (JPEG) a set of standardized image compression techniques, available for use by DICOM applications. Module a set of Attributes within an Information Object Definition that are logically related to each other. Example: Patient Module includes Patient Name, Patient ID, Patient Birth Date, and Patient Sex. Negotiation first phase of Association establishment that allows Application Entities to agree on the types of data to be exchanged and how that data will be encoded. Physical Media - a piece of material with recording capabilities for streams of bits. Characteristics of a Physical Media include form factor, mechanical characteristics, recording properties and rules for recording and organizing bit streams in accessible structures. Presentation Context the set of DICOM network services used over an Association, as negotiated between Application Entities; includes Abstract Syntaxes and Transfer Syntaxes. Protocol Data Unit (PDU) a packet (piece) of a DICOM message sent across the network. Devices must specify the maximum size packet they can receive for DICOM messages. Security Profile a set of mechanisms, such as encryption, user authentication, or digital signatures, used by an Application Entity to ensure confidentiality, integrity, and/or availability of exchanged DICOM data Service Class Provider (SCP) role of an Application Entity that provides a DICOM network service; typically, a server that performs operations requested by another Application Entity (Service Class User). Examples: Picture Archiving and Communication System (image storage SCP, and image query/retrieve SCP), Radiology Information System (modality worklist SCP). Service Class User (SCU) role of an Application Entity that uses a DICOM network service; typically, a client. Examples: imaging modality (image storage SCU, and modality worklist SCU), imaging workstation (image query/retrieve SCU) Service/Object Pair (SOP) Class the specification of the network or media transfer (service) of a particular type of data (object); the fundamental unit of DICOM 3

13 interoperability specification. Examples: Ultrasound Image Storage Service, Basic Grayscale Print Management. Service/Object Pair (SOP) Instance an information object; a specific occurrence of information exchanged in a SOP Class. Examples: a specific x-ray image. Tag a 32-bit identifier for a data element, represented as a pair of four digit hexadecimal numbers, the group and the element. If the group number is odd, the tag is for a private (manufacturer-specific) data element. Examples: (0010,0020) [Patient ID], (07FE,0010)[Pixel Data], (0019,0210)[private data element] Transfer Syntax the encoding used for exchange of DICOM information objects and messages. Examples: JPEG compressed (images), little endian explicit value representation. Unique Identifier (UID) a globally unique dotted decimal string that identifies a specific object or a class of objects; an ISO-8824 Object Identifier. Examples: Study Instance UID, SOP Class UID, SOP Instance UID. Value Representation (VR) the format type of an individual DICOM data element, such as text, an integer, a person s name, or a code. DICOM information objects can be transmitted with either explicit identification of the type of each data element (Explicit VR), or without explicit identification (Implicit VR); with Implicit VR, the receiving application must use a DICOM data dictionary to look up the format of each data element. 3.5 Acronyms, Abbreviations, and Symbols The following acronyms and abbreviations are used in this document. ACR AE CDR DICOM DIMSE DIMSE-C FSC FSR FSU HIS IHE IOD ISO JPEG American College of Radiology Application Entity Compact Disk Recordable Digital Imaging and Communications in Medicine DICOM Message Service Element DICOM Message Service Element-Composite File-Set Creator File-Set Reader File-Set Updater Hospital Information System Integrating the Healthcare Enterprise Information Object Definition International Standard Organization Joint Photographic Experts Group MODALITY Ultrasound System MPPS Modality Performed Procedure Step 4

14 MWL NEMA O PACS PDU R RIS SCP SCU SOP SR TCP/IP U UL VR US UID Modality Worklist National Electrical Manufacturers Association Optional (Key Attribute) Picture Archiving and Communication System Protocol Data Unit Required (Key Attribute) Radiology Information System Service Class Provider Service Class User Service Object Pair Structured Reporting Transmission Control Protocol/Internet Protocol Unique (Key Attribute) Upper Layer Value Representation Ultrasound Unique Identifier 3.6 References DICOM Quick Guide & FAQ, Revision 1.0 Final Text, Mindray Co. Ltd Digital Imaging and Communications in Medicine (DICOM), NEMA PS 3, available free at IHE Technical Framework, available free at 5

15 4 Networking 4.1 Implementation Model Application Data Flow Modality Verification AE (SCP) Verification SCU Request Echo Verification AE (SCU) Verification SCP Send Images, Reports,PDFs Storage AE (SCU) Storage SCP Request Commits,Update Status Storage Commitment AE(SCU) SC SCP Request Print Print AE (SCU) Print SCP Request Modality Worklist Worklist AE (SCU) Worlklist SCP Send MPPS Modality Performed Procedure Step AE(SCU) Modality PPS SCP Request Query/Retrieve Query/Retrieve AE(SCU) Query/Retrieve SCP Exam Database Storage AE (SCP) Storage SCU DICOM Standard Interface Figure 1 Implementation Model Note:Storage AE(SCP)only be used in Query/Retrieve This application entity provides a user interface, internal database and network listener that spawns additional threads as necessary to handle incoming connections. Conceptually the network services may be modeled as the following AE s, however, in fact all the AE s share a single (configurable) AE Title: Verification AE (as SCU and SCP) 6

16 Storage AE (as SCU and SCP) Storage Commitment AE(SCU) Print AE (as SCU) Worklist AE (as SCU) MPPS AE (as SCU) Query/Retrieve AE (as SCU) Functional Definitions of AE s Verification AE The ultrasound system supports the Verification service as a SCU and SCP. As a SCU, verification is activated when the verify button is selected on the dicom service configuration page where the verification results will also be showed to the user. As a SCP, verification AE waits in the background for connections, will accept associations with Presentation Contexts for SOP Class of the Verification Service Class, and will respond successfully to echo requests Storage AE As a SCU, the Storage AE originates associations for the transfer of DICOM Ultrasound single frame images, multi-frame images, secondary capture images, comprehensive structured reports,and Encapsulated PDFs to remote AE (selected from a pre-configured list).. The system supports automatic and manual storage. The operations for automatic storage service are described below: Operation 1 Step 1: Enable Send or printing after End Exam in the user preset. Step 2: End Exam, the ended exam (maybe include images, SRs, PDFs) would automatically send to the default storage service SCPs which are set to be default in the DICOM service preset dialog. Operation 2 Step 1: Open the system preset dialog and switch to the "key config" tab page. Step 2: Set the shortcut key which means sending image to the default DICOM storage SCPs. Step 3: During the examining, the user can press the Send key to send image to default DICOM storage service SCPs. 7

17 The operations for manual storage service are described below: Operation 1 Step 1: Select the images from thumbnail menu in main UI. Step 2: Press Send to button and select DICOM Storage service SCPs. Step 3: Send the image to the DICOM Storage service SCPs. Operation 2 Step 1: Select exams in the istation Dialog. Step 2: Press Send Exam and select DICOM Storage service. Step 3: Send the selected exams (maybe include images, SRs, PDFs) to the DICOM Storage service SCPs. Operation 3 Step 1: Select thumbnail in the istation Dialog. Step 2: Press Send to button and select DICOM Storage service SCPs. Step 3: Send the image to the DICOM Storage service SCPs. Operation 4 Step 1: Open the review dialog and select the images. Step 2: Press the Send To button to choose the storage SCPs. Step 3: Send the image to the DICOM Storage service SCPs. The SR only could be sent in the circumstance as below: The exam type is obstetric, gynecology, cardiac, vascular, breast. The SR Key for the exam type must be installed in option preset UI. Exam is the unit to send. The status of the exam is "End","Paused" or "Cancelled". SR would not be sent when an active exam is selected. The DICOM storage service SCPs should be set as "Attach SR when Store Images", Attach SR When Store Images and SR Contains User-defined Measurements, Only Store SR and It Contains User-defined Measurements or "Only Store SR". The Encapsulated PDF only could be sent in the circumstance as below: Exam is the unit to send. The status of the exam is "End","Paused" or "Cancelled". Encapsulated PDF would not be sent when an active exam is selected. The "Encapsulated PDF" should be enabled in DICOM storage service preset. 3D/4D images could send as pre-configuration form,. 8

18 Table 4 3D/4D Transfer Option 3D/4D Option Sop Class Sop Class UID Normal US Image Storage US Multiframe Image Storage Volume Enhanced US Volume Storage Rawdata Raw Data Storage Transfer with Rawdata form is mainly used for 4DViewer to get the raw data of the image. The Storage SCP received the image could not review it because the image information is coded in private form. 4DViewer or DC8 Series Diagnostic Ultrasound System could retrieve the file and review it. In the event that the ultrasound system is taken off the network as a portable system or when a network failure occurs during a background store, the Storage SCU maintains a queue of failed C-STORE requests. If pre-configured on Preset UI, the failed C-Store requests will be automatically retried specified times. If no pre-configuration, the user can also retry the failed requests manually. As a SCP, the Storage AE could only be used in Query/Retrieve, otherwise couldn't Storage Commitment AE The Storage Commitment AE originates associations to ensure the reliable storage of DICOM composite information objects on remote DICOM device after sending DICOM Storage Service to the device. The Storage Commitment service will be executed automatically in the circumstance as below: The Storage Commitment Service is set to associate with the Storage Service in DICOM storage service preset dialog and the associated Storage Service is executed. Exam is the unit to send. The status of the exam is "End". It would not be executed when an "Active","Paused" or "Cancelled" exam is selected Print AE As a SCU, the Print AE originates associations for the print of DICOM Ultrasound single frame images and secondary capture images to remote AE (selected from a pre-configured list). The system is capable of grayscale (B/W) and color print supporting with automatic and manual print functions. 9

19 The operations for automatic print service are described below: Operation 1 Step 1: Enable Send or printing after End Exam in the user preset. Step 2: End Exam, the single frame images and secondary capture images of ended exam would automatically send to the default print service SCPs which are set to be default in the DICOM service preset dialog. Notes: This operation associates with the Display Format of the DICOM print preset, the DICOM print will be not active until one page is filled with the images or the exam end. For example, if the Display Format has been set to STANDARD\2,3, the DICOM print will be not active until the shortcut key has been pressed 6 times. However, when the exam end, the DICOM print will be active even if one page is not filled. Operation 2 Step 1: Open the system preset dialog and switch to the "key config" tab page. Step 2: Set the shortcut key which means sending image to the default DICOM print SCPs. Step 3: During the examining, the user can press the print key to send image to default DICOM print service SCPs. The operations for manual print service are described below: Operation 1 Step 1: Select the images from thumbnail menu in main UI. Step 2: Press Send to button and select DICOM print service SCPs. Step 3: Send the image to the DICOM print service SCPs. Operation 2 Step 1: Select exams in the istation Dialog. Step 2: Press Send Exam and select DICOM print service SCPs. Step 3: Send the single frame images and secondary capture images of the selected exams to the DICOM print service SCPs. Operation 3 Step 1: Select thumbnail in the istation Dialog. Step 2: Press Send to button and select DICOM print service SCPs. Step 3: Send the image to the DICOM print service SCPs. Operation 4 Step 1: Open the review dialog and select the images. 10

20 Step 2: Press the Send To button to choose the print SCPs. Step 3: Send the image to the DICOM print service SCPs Worklist AE The Worklist AE is activated through the Worklist UI when the user selects a remote AE to query (from a pre-configured list).the system supports automatic and manual query depending on its configuration on Preset UI. The system supports fuzzy query using? and *. If set one and only one remote AE to be default status. The system can initiate a query with default rules when show the Worklist UI. The Worklist Server is the default server. The Modality Type is US, the Exam Date is today, and the Scheduled Station AE Title is blank. Alternatively if the default status is no, the user can specify query rules on Worklist UI. Such as Patient ID, Patient Name, Accession Number, Requested Procedure ID, Worklist Server, Exam Date, Modality Type and Scheduled Station AE Title. If no matches are found, a dialogue will be presented to the user to indicate so. The possible reasons for this failure are listed to help trouble shooting. If more than one matching patients found, user can discover lists number on the UI. The user can also change query rules for another query, or for further filter in local database to locate the patients quickly. And the lists can be sorted in ascending or descending order MPPS AE MPPS AE sends event transactions that facilitate the transfer of exam procedure status from the ultrasound system to the information system. MPPS messages are sent from the system under the following circumstances: MPPS N-Create, Status = IN PROGRESS. Starting a new exam or reactive an exam result in automated creation of an MPPS Instance managed by a remote AE. MPPS N-Set, Status = COMPLETE. Completion of the MPPS is performed as the result of an operator action of ending the exam. MPPS N-Set, Status = DISCONTINUED. Cancel Exam causes the Discontinued status to be sent. User can select various reasons from the Reason of cancel Exam UI when need to cancel an exam Query/Retrieve AE The Query/Retrieve AE supports the Query/Retrieve services as an SCU. As a Query SCU, the system initiates a C-Find request to the remote SCP if pre-configured on the Preset UI, and then query is invoked directly by the user. The system supports fuzzy query using? and *. 11

21 For remote AE, no matter what the default status is, the user can specify query rules on Query/Retrieve UI. Such as Patient ID, Patient Name, Accession Number, Exam Date and select Search Key. If no matches are found, a dialogue will be presented to the user to indicate so. The user can also change query rules for another query, or for further filter in local database to locate the patients quickly. As a Move SCU, the system supports the Study Root Query Model. The stystem can only retrieve ultrasound images or structed reports, whose modality atrributes are "US" or "SR", but will leap all the other ones. Furthermore, the retrieval destination is only local host. The system initiates a C-MOVE request to the remote Retrieve SCP when user selects items to retrieve. The remote Retrieve SCP in turn starts C-STORE sub operations to the ultrasound system. User can discover lists number for queried items, as well as retrieval items. And the lists can be sorted in ascending or descending order. The system can retrieve the 3D/4D images that have sent to PACS or other Storage SCP in rawdata form. After retrieveing, the system can convert it to the identifiable format and review it Sequence of Real World Activities All SCP activities are performed asynchronously in the background and not dependent on any sequencing. All SCU activities are sequentially initiated in the user interface, and another activity may not be initiated until the prior activity has completed. 4.2 AE Specifications Modality AE SOP Classes The ultrasound system provides Standard Conformance to the following SOP Class: Table 5 SOP Class for Modality AE SOP Class Name SOP Class UID SCU SCP Verification SOP Class Yes Yes US Image Storage Yes Yes 1 US Multiframe Image Storage Yes Yes 1 12

22 Secondary Capture Image Storage Yes Yes 1 Comprehensive Structured Report Storage Yes Yes 1 Encapsulated PDF Storage Yes Yes 1 Enhanced US Volume Storage Yes No Raw Data Storage Yes Yes Storage Commitment Push Model Yes No Basic Grayscale Print Management Meta Yes No Basic Color Print Management Meta SOP Class Yes No Basic Film Session SOP Class Yes No Basic Film Box SOP Class Yes No Basic Grayscale Image Box SOP Class Yes No Printer SOP Class Yes No Print Job SOP Class Yes No Modality Worklist Information Model Find Yes No Modality Performed Procedure Step SOP Class Yes No Study Root Query/Retrieve Information Model - Find Yes No Study Root Query/Retrieve Information Model - Move Yes No Note:1 Yes only used in Query/Retrieve, otherwise No Association Establishment Policies General The DICOM standard application context name for DICOM 3.0 is always proposed: Table 6 DICOM Application Context for Modality AE Application Context Name The PDU size is configurable with a minimum size of 16,384 and a maximum size of 65,536. The default PDU size is 32, Number of Associations The system initiates one Association at a time for each destination to which a transfer request is being processed in the active job queue list. Since Storage and Print tasks are executed within a same thread, when they are selected simultaneously, only one job will be active at a time, the other(s) remain pending until the active job is successful or failed. Table 7 Number of Associations as an Association Initiator 13

23 Maximum number of simultaneous associations 1 Table 8 Number of Associations as an Association Acceptor Maximum number of simultaneous associations Asynchronous Nature The ultrasound system will only allow a single outstanding operation on an association Implementation Identifying Information Table 9 DICOM Implementation Class and Version for Modality AE Implementation Class UID Implementation Version Name MINDRAY_V Association Initiation Policy Activity Request Echo Description and Sequencing of Activities The user can verify the existence of a DICOM server on the hospitals network, through a button in the DICOM Service screen. When the user presses this button, the ultrasound system will initiate the association. Figure 2 Sequencing of Activity Send Echo Request Proposed Presentation Contexts The Verification AE (as SCU) supports the following Presentation Contexts for Verification. Table 10 Presentation Contexts for Verification 14

24 PROPOSED PRESENTATION CONTEXTS Abstract Syntax Transfer Syntax Role Ext. Name UID Name UID Neg. Verification Implicit VR Little Endian SCU None Explicit VR Little Endian SCU None Explicit VR Big Endian SCU None SOP Specific Conformance It summarizes the behavior of Ultrasound System when receiving status codes in a C-ECHO response. Table 11 Verification C-Echo Response Status Handling Behavior Service Status Further Meaning Error Code Behavior (as SCU) Success Success 0000 Device Status is set to: Verify Successful Refused Out of Resources A7XX Device Status is set to: Verify Failed Failed Unable to process CXXX Device Status is set to: Verify Failed * * Any other status code Device Status is set to: Verify Failed Activity Store images, SRs, PDFs Description and Sequencing of Activities For each exam, image selected from the user interface to be transferred, an attempt will be made to transfer it to the selected remote AE. When the storage fails, not only the failed task will automatically retry specific times if configured on Preset UI, but also user can restart the failed task by pressing Retry Button on the ultrasound task management dialog. Besides that, in the event that the ultrasound system is taken off the network or when a network failure occurs during a background store, the Storage SCU maintains a queue of failed C-STORE requests. Once the network is restored, the system will retry automaticlly. Structured Reports will contain only a part of common used measurements and calculations created by ultrasound system, and User-defined measurements or calculations can also be sent in SR If custom measurements or calculations were defined, and the User-defined measurements SR storage option is checked, then all User-defined measurements or calculations will be formated as a xml-style string, the string will be contained in a private element( ,mrus, "self-defined-measurementfile") in SR(SR with User-defined measurements must generate under English system), and the User can identify User-defined measurements through parsing this string. 15

25 The OB and Gyn exam types create OB-GYN Ultrasound Procedure Reports. The Adult Card exam type creates Adult Echocardiography Reports. The Abd, Uro and Vas exam types create Vascular Reports The Breast exam types create Breast Imaging Reports. upon successful completion of an end exam Commit Status Update Figure 3 Sequencing of Activity Send Storage Request Proposed Presentation Contexts If Storage AE is offered a choice of Transfer Syntaxes in the accepted Presentation Contexts, it will apply the first encountered to use for the C-STORE operation. As to Compress Transfer Syntaxes, it will apply the user configured one. Table 12 Proposed Presentation Contexts for Storage PROPOSED PRESENTATION CONTEXTS Abstract Syntax Transfer Syntax Role Ext. Name UID Name UID Neg. US Image Storage Implicit VR Little Endian SCU None Explicit VR Little Endian SCU None JPEG Lossy, Baseline SCU None 16

26 Sequential with Huffman Coding (Process 1) 50 Explicit VR Big Endian SCU None JPEG Lossless, SCU None Non-Hierarchical, 70 First-Order Prediction (Process 14 [Selection Value 1]) RLE Lossless SCU None JPEG 2000 Image SCU None Compression (Lossless 90 Only) JPEG 2000 Image SCU None Compression 91 US Multiframe Image Storage Implicit VR Little Endian SCU None Explicit VR Little Endian SCU None JPEG Lossy, Baseline SCU None Sequential with Huffman Coding (Process 1) 50 Explicit VR Big Endian SCU None JPEG Lossless, SCU None Non-Hierarchical, 70 First-Order Prediction (Process 14 [Selection Value 1]) RLE Lossless SCU None JPEG 2000 Image SCU None Compression (Lossless 90 Only) JPEG 2000 Image SCU None Compression 91 Secondary Capture Image Storage Implicit VR Little Endian SCU None Explicit VR Little Endian SCU None JPEG Lossy, Baseline Sequential with Huffman Coding (Process 1) SCU None 17

27 Explicit VR Big Endian SCU None JPEG Lossless, SCU None Non-Hierarchical, 70 First-Order Prediction (Process 14 [Selection Value 1]) RLE Lossless SCU None JPEG 2000 Image SCU None Compression (Lossless 90 Only) JPEG 2000 Image SCU None Compression 91 Comprehensi ve Structured Report Storage Implicit VR Little Endian SCU None Explicit VR Little Endian SCU None JPEG Lossy, Baseline SCU None Sequential with Huffman Coding (Process 1) 50 Explicit VR Big Endian SCU None JPEG Lossless, SCU None Non-Hierarchical, 70 First-Order Prediction (Process 14 [Selection Value 1]) RLE Lossless SCU None JPEG 2000 Image SCU None Compression (Lossless 90 Only) JPEG 2000 Image SCU None Compression 91 Encapsulated PDF Storage Implicit VR Little Endian SCU None Explicit VR Little Endian SCU None JPEG Lossy, Baseline SCU None Sequential with Huffman Coding (Process 1) 50 Explicit VR Big Endian SCU None JPEG Lossless, SCU None Non-Hierarchical, 70 18

28 First-Order Prediction (Process 14 [Selection Value 1]) RLE Lossless SCU None JPEG 2000 Image SCU None Compression (Lossless 90 Only) JPEG 2000 Image SCU None Compression 91 Enhanced US Volume Storage Implicit VR Little Endian SCU None Explicit VR Little Endian SCU None JPEG Lossy, Baseline SCU None Sequential with Huffman Coding (Process 1) 50 Explicit VR Big Endian SCU None JPEG Lossless, SCU None Non-Hierarchical, 70 First-Order Prediction (Process 14 [Selection Value 1]) RLE Lossless SCU None JPEG 2000 Image SCU None Compression (Lossless 90 Only) JPEG 2000 Image SCU None Compression 91 Raw Data Storage Implicit VR Little Endian SCU None Explicit VR Little Endian SCU None JPEG Lossy, Baseline SCU None Sequential with Huffman Coding (Process 1) 50 Explicit VR Big Endian SCU None JPEG Lossless, SCU None Non-Hierarchical, 70 First-Order Prediction (Process 14 [Selection Value 1]) RLE Lossless SCU None JPEG 2000 Image SCU None Compression (Lossless 90 19

29 Only) JPEG 2000 Image SCU None Compression SOP Specific Conformance Storage AE provides Standard Conformance to the Storage Service Class. Storage AE will behave as described in the Table below in response to the status returned in the C-STORE response command message. Table 13 Storage C-STORE Response Status Handling Behavior Service Further Error Behavior Status Meaning Code Success Success 0000 Image transmission is successful, The status code is logged and the task success is reported to the user via task management. Refused Out of A7xx The association is aborted using A-ABORT and the Resources send task is marked as failed. The reason is logged and, If user selects the failed task, the reasons for this failure will be showed via task management. Error Data Set does A9xx The association is aborted using A-ABORT and the not match SOP send task is marked as failed. The reason is logged and, Class If user selects the failed task, the reasons for this failure will be showed via task management. Error Cannot Cxxx The association is aborted using A-ABORT and the Understand send job is marked as failed. The reason is logged and, If user selects the failed task, the reasons for this failure will be showed via task management. Failure Any other xxxx The association is aborted using A-ABORT and the failure send job is marked as failed. The reason is logged and, If user selects the failed task, the reasons for this failure will be showed via task management. Warning Coercion of B000 Image transmission is considered successful but the Data Elements status meaning is logged. Data Set does B007 Image transmission is considered successful but the not match SOP status meaning is logged. Class Elements B006 Image transmission is considered successful but the Discarded status meaning is logged. Any other status xxxx The Association is aborted using A-ABORT and the code. send job is marked as failed. The status code is logged 20

30 and the job failure is reported to the user via task management. The behavior during communication failure is summarized in the Table below: Table 14 Storage Communication Failure Behavior Exception Behavior Timeout Association aborted by the SCP or network layers The Association is aborted using A-ABORT and the send job is marked as failed. The reason is logged and the job failure is reported to the user via task management. The send job is marked as failed. The reason is logged and the job failure is reported to the user via task management. The following tables provide the list of attributes requested in the Storage. Table 15 US Image IOD IE Patient Study Module Patient General Study Patient Study Series Equipment Image General Series General Equipment General Image Image Pixel US Region Calibration US Image SOP Common Table 16 US Multi-Frame Image IOD 21

31 IE Patient Study Series Equipment Image Module Patient General Study Patient Study General Series General Equipment General Image Image Pixel Cine Multi-frame US Region Calibration US Image SOP Common Table 17 SC Image IOD IE Patient Study Series Equipment Image Module Patient General Study Patient Study General Series General Equipment SC Equipment General Image Image Pixel SC Image SOP Common Table 18 Encapsulated PDF IOD 22

32 IE Patient Study Series Equipment Encapsulated Document Module Patient General Study Patient Study Encapsulated Document General Equipment SC Equipment Encapsulated Document SOP Common Table 19 Raw Data IOD IE Patient Study Series Equipment Raw Data Module Patient General Study Patient Study General Series General Equipment Acquisition Context Raw Data SOP Common Table 20 IE Patient Study Series Frame of Reference Equipment Image Enhanced US Volume IOD Module Patient General Study Patient Study General Series Enhanced US Series Frame of Reference Ultrasound Frame of Reference Synchronization General Equipment Enhanced General Equipment General Image Image Pixel Multi-frame Functional Groups Multi-frame Dimension 23

33 Acquisition Context Enhanced US Image SOP Common Table 21 Patient Module ATTRIBUTE VR TYPE ATTRIBUTE NAME VALUE(S) AND COMMENTS (0010,0010) PN 2 Patient's Name MWL/USER (0010,0020) LO 2 Patient ID MWL/USER (0010,0030) DA 2 Patient's Birth Date MWL/USER, default is set to zero length (0010,0040) CS 2 Patient's Sex MWL/USER, default is set to zero length (0010,1000) LO 3 Other Patient IDs MWL/USER (0010,2160) SH 3 Ethnic Group MWL (0010,4000) LT 3 Patient Comments MWL/USER Table 22 General Study Module ATTRIBUTE VR TYPE ATTRIBUTE NAME VALUE(S) AND COMMENTS (0008,0020) DA 2 Study Date AUTO (0008,0030) TM 2 Study Time AUTO (0008,0050) SH 2 Accession Number MWL/USER, default is set to zero length (0008,0090) PN 2 Referring Physician's Name MWL/USER, default is set to zero length (0008,1030) LO 3 Study Description MWL/USER, default is set to zero length (0008,1032) SQ 3 Procedure Code Sequence MWL (0020,000D) UI 1 Study Instance UID MWL/AUTO (0020,0010) SH 2 Study ID AUTO Table 23 Patient Study Module ATTRIBUTE VR TYPE ATTRIBUTE NAME VALUE(S) AND COMMENTS (0008,1080) LO 3 Admitting Diagnoses Description MWL 24